title: Severe and morbid obesity in Crohn's disease patients: prevalence and disease associations.
abstract: BACKGROUND
  Crohn's disease (CD) is frequently associated with weight loss and malnutrition. However, as the prevalence of obesity increases worldwide, it may become a clinical problem even in CD.
  
  
  OBJECTIVE
  To assess the prevalence of severe/morbid obesity in CD patients and to compare their disease characteristics to nonobese CD patients.
  
  
  METHODS
  A retrospective analysis of a computerized CD patient database was performed to identify severely/morbidly obese patients (BMI >35). Prevalence was compared to data of the general population. Severely/morbidly obese CD patients were then compared to randomly selected nonobese CD patients (BMI <30) in a 1:3 ratio.
  
  
  RESULTS
  Thirteen severely/morbidly obese patients out of 560 CD patients were found (2.3%), which is significantly lower than the prevalence in the general population (5.6%, p = 0.001). When compared to 39 nonobese CD patients, colonic disease was significantly more common among severely/morbidly obese CD patients (odds ratio: 6, 95% CI: 1.35-26.3, p = 0.02), while there was no difference in other disease parameters. Interestingly, 4 morbidly obese CD patients had undergone laparoscopic sleeve gastrectomy for treatment of morbid obesity with a favorable surgical course.
  
  
  CONCLUSIONS
  CD in severely/morbidly obese patients is more often colonic, but otherwise no different than CD in nonobese patients. Sleeve gastrectomy is a viable therapeutic option for morbidly obese CD patients.
authors.affiliation: Department of Internal Medicine D, Sheba Medical Center, Tel Hashomer and Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel. bellageyshis@gmail.com
authors.forename: Bella
authors.initials: B
authors.lastname: Ungar
authors.forename: Uri
authors.initials: U
authors.lastname: Kopylov
authors.forename: David
authors.initials: D
authors.lastname: Goitein
authors.forename: Adi
authors.initials: A
authors.lastname: Lahat
authors.forename: Eitan
authors.initials: E
authors.lastname: Bardan
authors.forename: Benjamin
authors.initials: B
authors.lastname: Avidan
authors.forename: Alon
authors.initials: A
authors.lastname: Lang
authors.forename: Yaakov
authors.initials: Y
authors.lastname: Maor
authors.forename: Rami
authors.initials: R
authors.lastname: Eliakim
authors.forename: Shomron
authors.initials: S
authors.lastname: Ben-Horin
mesh_terms: D000328:Adult; D050110:Bariatric Surgery; D016022:Case-Control Studies; D003424:Crohn Disease / Q000150:complications / Q000453:epidemiology* / Q000601:surgery; D005260:Female; D006801:Humans; D007557:Israel / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications / Q000453:epidemiology* / Q000601:surgery; D015995:Prevalence; D012189:Retrospective Studies; D055815:Young Adult